Enteroclysis: The Small Bowel Enema (cont.)
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Duodenal Intubation |
- For enteroclysis, infusion of contrast fluid
is done through a tube inserted into the distal duodenum or proximal
jejunum.
- The tip of the tube must be inserted at
least as far as the 4th portion of the duodenum to avoid reflux into the
stomach. Gastric reflux will cause nausea, vomiting, and loss of
prograde peristalsis, thus retarding or halting the examination.
- The catheter used for intubation is a
modification of the Bilbao-Dotter tube, a radiopaque 14 French, 120 cm.
long tube with a closed end and multiple side holes. The tube is
stiffened and directed with a curved-tip, teflon-coated torque cable. We
use one of two modifications which are narrower and longer than the
original Bilbao-Dotter tube: either the 12 French, 135 cm. Herlinger
modification (Cook Inc., Bloomington, IN) or the 13 Fr., 155 cm.
Maglinte modification (Lafayette Pharmacal Inc., Lafayette, IN). The
latter tube has a 15 ml capacity balloon proximal to the side holes
which can be inflated to prevent reflux of contrast fluid into the
stomach.
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